Cervical myelopathy is a collection of symptoms resulting from the compression of the spinal cord, often occurring in the upper spine. In simple terms, this condition resembles a blocked motorway, disrupting traffic in both directions within the spinal cord. The compression compromises blood supply, leading to cord damage, and distinct color changes on MRI scans.
MRI of the neck showing cord signal change (Red arrow) suggestive of myelopathy. This is an example of movement related compression rather than age related stenosis.
Causes of Cord Compression
While age-related degenerative changes are the primary cause, various other factors can contribute to cord compression, including tumors, infections, and trauma. Some individuals may experience stenosis in both the upper and lower spine, akin to lumbar stenosis but affecting a different spinal segment.
Impact on Daily Life
Cervical myelopathy can affect hand functions, such as opening jars and buttoning clothes, as well as balance maintenance. Patients often report recurrent falls, describe their legs as feeling weak or like jelly, and struggle with basic daily activities. The condition is characterized by a step-ladder type progression, with periods of stability followed by sudden deterioration and subsequent stability.
Will It Progress?
Predicting the progression of cervical myelopathy can be challenging. Roughly one-fourth of patients experience slow progression, while the remainder remain stable. Even stable patients require close monitoring as progression is unpredictable. Those with progressive symptoms need evaluation and the development of a tailored management plan.
The Role of Surgery
Operative interventions primarily aim to alleviate pressure on the spinal cord or “superhighway.” The extent and method of surgery depend on the severity and nature of compression, ranging from procedures like ACDF to laminectomy and beyond.
Understanding cervical myelopathy is crucial for informed decision-making and tailored treatment plans.
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Note: Medical conditions should always be discussed with a qualified healthcare professional. This content is for informational purposes only.